Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9...Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.展开更多
Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, w...Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.展开更多
Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with i...Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.展开更多
Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of h...Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.展开更多
Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, Am...Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists （ACOG） updated the diagnostic criteria for PE and redtlced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods： Complete clinical data of 65 patients with hypertensive disorder in pregnancy （HDP） were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verily the result of Spearman correlation test. Results： Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria 〈0.3 /24 h. The statistic difference was significant （P = 0.000）. However, no significant difference was tbund in other criteria groups （impaired liver function： P = 0.417; renal insufficiency： P = 0.194; thrombocytopenia： P - 0.079： and cerebral or visual symptoms： P = 0.296）. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0.557 （P 〈 0.005）. hnpaired liver function （P = 0.180）, renal insufficiency （P =0.077） and cerebral or visual symptoms （P = 0.118） were not related to adverse outcomes, The 24-h proteinuria value （HDP： r= 0.685; PE： r= 0.521）, liver enzyme value （HDP： r= 0.519; PE： r= 0.501）, and creatinine value （HDP： r= 0.511; PE： r= 0.398） were associated with adverse pregnancy outcomes both in PE and HDP, and the corresponding logistic regression equation can be produced. Conclusions： The 24-h proteinuria value is still an important diagnostic criterion for PE, and deletion of 24-h proteinuria value from diagnostic criteria for severe PE was not recommended. The diagnostic criteria in ACOG guideline need to be verified in Chinese women.展开更多
文摘Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.
基金The present study was supported by the National Natural Science Foundation of China(Grant No.82003415)the National Key Research&Development(R&D)Program of China(Grant No.2021YFC2700705).
文摘Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.
基金This study was funded by the Indonesia Endowment Fund for Education(LPDP)with Reference number S-422/LPDP.3/2018.
文摘Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.
文摘Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.
文摘Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists （ACOG） updated the diagnostic criteria for PE and redtlced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods： Complete clinical data of 65 patients with hypertensive disorder in pregnancy （HDP） were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verily the result of Spearman correlation test. Results： Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria 〈0.3 /24 h. The statistic difference was significant （P = 0.000）. However, no significant difference was tbund in other criteria groups （impaired liver function： P = 0.417; renal insufficiency： P = 0.194; thrombocytopenia： P - 0.079： and cerebral or visual symptoms： P = 0.296）. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0.557 （P 〈 0.005）. hnpaired liver function （P = 0.180）, renal insufficiency （P =0.077） and cerebral or visual symptoms （P = 0.118） were not related to adverse outcomes, The 24-h proteinuria value （HDP： r= 0.685; PE： r= 0.521）, liver enzyme value （HDP： r= 0.519; PE： r= 0.501）, and creatinine value （HDP： r= 0.511; PE： r= 0.398） were associated with adverse pregnancy outcomes both in PE and HDP, and the corresponding logistic regression equation can be produced. Conclusions： The 24-h proteinuria value is still an important diagnostic criterion for PE, and deletion of 24-h proteinuria value from diagnostic criteria for severe PE was not recommended. The diagnostic criteria in ACOG guideline need to be verified in Chinese women.
